title: [Data of coronary angiography and normal stress myocardial perfusion scintigraphy].
abstract: OBJECTIVE
  To determine informativity of clinical variables in predicting significant coronary artery disease in patients with chest pain and normal stress myocardial perfusion scintigraphy.
  
  
  METHODS
  This study was a retrospective analysis of data of coronary angiography performed in 84 patients with chest pain and normal stress myocardial perfusion scintigraphy during 2000-2007. Single-photon emission computed tomography was performed following a one-day protocol (stress-rest). A 5-point (0-4) scoring system in a 20-segment model was used for interpretation of results. Myocardial perfusion was considered normal if the sum of stress scores was 0 to 3.
  
  
  RESULTS
  High pretest probability and informative exercise-terminating criteria were documented in 25% and 45.2% of patients, respectively. Significant coronary artery disease (stenosis ≥ 75%) was determined in 26 (31%) patients with normal myocardial perfusion scintigraphy: 15 (17.9%) patients had coronary artery disease of a single vessel, 5 (6%) of two vessels, and 6 (7.1%) of three vessels. Univariate logistic regression analysis showed that patients with typical angina and high pretest probability were more likely to have significant stenosis of one to three arteries (odds ratios, 3.8; P=0.008 and 3.43; P=0.023, respectively). Three-vessel disease was more often documented in patients with typical angina (odds ratio, 11.2; P=0.009), high pretest probability (odds ratio, 7.93; P=0.018), and signs of ischemia during exercise test (odds ratio, 6.4; P=0.037).
  
  
  CONCLUSIONS
  Patients with typical angina, high pretest probability, and signs of ischemia during exercise test have an increased probability of having significant coronary artery disease despite normal stress myocardial perfusion scintigraphy; therefore, this group of patients should undergo coronary angiography.
authors.affiliation: Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Suki-lėlių 17, 50161 Kaunas, Lithuania. irena.milvidaite@kmuk.lt
authors.forename: Irena
authors.initials: I
authors.lastname: Milvidaitė
authors.forename: Ilona
authors.initials: I
authors.lastname: Kulakienė
authors.forename: Nemira
authors.initials: N
authors.lastname: Jurkienė
authors.forename: Leonarda
authors.initials: L
authors.lastname: Linonienė
authors.forename: Laima
authors.initials: L
authors.lastname: Gugienė
authors.forename: Janina
authors.initials: J
authors.lastname: Kanaporienė
authors.forename: Dalia
authors.initials: D
authors.lastname: Lukšienė
authors.forename: Ramūnas
authors.initials: R
authors.lastname: Navickas
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D012189:Retrospective Studies; D013312:Stress, Physiological